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目的分析单中心肾嫌色细胞癌的临床特征,探讨与肾嫌色细胞癌预后相关的临床指标。方法通过回顾性分析2005年1月—2015年5月在上海长海医院住院手术,且经术后病理学检查证实为肾嫌色细胞癌的113例患者的临床、病理和随访资料。研究终点为总生存期,生存分析数据采用Kaplan-Meier法进行计算,并用Log-rank法对生存率进行分析比较。结果肾嫌色细胞癌占同期所有肾细胞癌的4.8%(113/2 355),患者中位年龄为50.96岁,男女比例为1.01∶1,80例(70.8%)无症状。肾嫌色细胞癌的1、3、5年生存率分别为98.2%(108/110)、96.4%(106/110)、95.5%(105/110)。本组中Ⅰ型肾嫌色细胞癌107例,Ⅱ型肾嫌色细胞癌6例。肾嫌色细胞癌单因素Kaplan-Meier预后分析显示,Ⅱ型肾嫌色细胞癌的预后有好于Ⅰ型的趋势,但差异无统计学意义(P=0.515);不同症状、不同T分期和美国癌症联合委员会(AJCC)分期的肾嫌色细胞癌患者预后的差异均有统计学意义(P值均<0.05)。结论肾嫌色细胞癌是预后较好的肾癌亚型之一,其中Ⅱ型预后相对更好。患者的症状、肿瘤的大小和AJCC分期可以作为判断肾嫌色细胞癌预后的重要因素。
Objective To analyze the clinical characteristics of single center renal cell carcinoma and to explore the clinical indicators related to the prognosis of chromophobe renal cell carcinoma. Methods We retrospectively analyzed the clinical, pathological and follow-up data of 113 patients who were admitted to Shanghai Changhai Hospital from January 2005 to May 2015 and who were confirmed as renal cell carcinoma by postoperative pathology. The end point of the study was overall survival. Survival data were calculated using the Kaplan-Meier method, and survival was analyzed using the Log-rank method. Results Kidney chromophobe accounted for 4.8% (113/2 355) of all renal cell carcinoma in the same period. The median age of patients was 50.96 years old. The ratio of male to female was 1.01:1. There were 80 cases (70.8%) asymptomatic. The 1, 3, 5-year survival rates of chromophobe renal cell carcinoma were 98.2% (108/110), 96.4% (106/110) and 95.5% (105/110), respectively. In this group, 107 cases of type I renal chromophobe carcinoma and 6 cases of type 2 chromophobe renal cell carcinoma. Kaplan-Meier prognosis of chromophobe renal cell carcinoma showed that the prognosis of type Ⅱ renal chromophobe carcinoma was better than that of type Ⅰ, but the difference was not statistically significant (P = 0.515); different symptoms, different T stage and The prognosis of patients with renal cell carcinoma of the chromophobe staged by the American Joint Commission on Cancer (AJCC) was statistically significant (P all <0.05). Conclusion Kidney chromophobe carcinoma is one of the subgroups of renal cell carcinoma with better prognosis, and type Ⅱ prognosis is relatively better. The patient’s symptoms, tumor size, and AJCC staging can be important prognostic factors for chromophobe renal cell carcinoma.